Multidisciplinary rehabilitation for subacute low back pain: graded activity or workplace intervention or both?: a randomized controlled trial

Anema, Johannes R., Steenstra, Ivan A., Bongers, Paulien, de Vet, Henrica C. W., Loisel, Patrick and van Mechelen, Willem (2007) Multidisciplinary rehabilitation for subacute low back pain: graded activity or workplace intervention or both?: a randomized controlled trial. Spine, 32 3: 291-298. doi:10.1097/01.brs.0000253604.90039.ad


Author Anema, Johannes R.
Steenstra, Ivan A.
Bongers, Paulien
de Vet, Henrica C. W.
Loisel, Patrick
van Mechelen, Willem
Title Multidisciplinary rehabilitation for subacute low back pain: graded activity or workplace intervention or both?: a randomized controlled trial
Journal name Spine   Check publisher's open access policy
ISSN 0362-2436
Publication date 2007-02-01
Sub-type Article (original research)
DOI 10.1097/01.brs.0000253604.90039.ad
Volume 32
Issue 3
Start page 291
End page 298
Total pages 8
Place of publication Hagerstown, MD, United States
Publisher Lipponcott-Raven
Language eng
Subject 1103 Clinical Sciences
Abstract Study design. Population-based randomized controlled trial. Objective. To assess the effectiveness of workplace intervention and graded activity, separately and combined, for multidisciplinary rehabilitation of low back pain (LBP). Summary of Background Data. Effective components for multidisciplinary rehabilitation of LBP are not yet established. Methods. Participants sick-listed 2 to 6 weeks due to nonspecific LBP were randomized to workplace intervention (n = 96) or usual care (n = 100). Workplace intervention consisted of workplace assessment, work modifications, and case management involving all stakeholders. Participants still sick-listed at 8 weeks were randomized for graded activity (n = 55) or usual care (n = 57). Graded activity comprised biweekly 1-hour exercise sessions based on operant-conditioning principles. Outcomes were lasting return to work, pain intensity and functional status, assessed at baseline, and at 12, 26, and 52 weeks after the start of sick leave. Results. Time until return to work for workers with workplace intervention was 77 versus 104 days (median) for workers without this intervention (P = 0.02). Workplace intervention was effective on return to work (hazard ratio = 1.7; 95% CI, 1.2-2.3; P = 0.002). Graded activity had a negative effect on return to work (hazard ratio = 0.4; 95% CI, 0.3-0.6; P < 0.001) and functional status. Combined intervention had no effect. Conclusion. Workplace intervention is advised for multidisciplinary rehabilitation of subacute LBP. Graded activity or combined intervention is not advised.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Human Movement and Nutrition Sciences Publications
 
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